V.I.T.A.M. in COVID 19: A Systematic Approach to a Global Pandemic

Introduction In the unprecedented era of COVID-19, ongoing research and evolution of evidence has led to ever-changing guidelines for clinical monitoring and therapeutic options. Formulating treatment protocols requires the understanding and application of the evolving research. Objective The primary objective of this study is to present a systematic evidence-based approach to synthesize the necessary data in order to optimize the management of COVID-19. Methods At Mayo Clinic Florida, we developed a multidisciplinary centralized COVID Treatment Review Panel (TRP) of expert pulmonologists, intensivists, infectious disease specialists, anesthesiologists, hematologists, rheumatologists, and hospitalists that in real-time reviews the latest evidence in peer-reviewed journals, the available clinical trials, and help guide the rapid application of therapeutics or interventions to the patient and the bedside provider. Results/Conclusions The multi-disciplinary team approach of synthesizing clinical data and coordinating care is effective in responding to rapidly evolving and changing evidence. Systematic data collection and evidence-based treatment algorithms enable physicians to rapidly translate the current literature to clinical practice, and improve care and outcomes of patients.

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Surviving sepsis: a trust-wide approach. A multi-disciplinary team approach to implementing evidence-based guidelines

Nursing in Critical Care ◽

10.1111/j.1478-5153.2009.00378.x ◽

2010 ◽

Vol 15 (3) ◽

pp. 141-151 ◽

Cited By ~ 8

Author(s):

Karin Gerber

Keyword(s):

Team Approach ◽

Evidence Based ◽

Evidence Based Guidelines ◽

Multi Disciplinary Team

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Faculty Opinions recommendation of Implementation of evidence-based treatment protocols to manage fever, hyperglycaemia, and swallowing dysfunction in acute stroke (QASC): a cluster randomised controlled trial.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.13399002.14858058 ◽

2012 ◽

Author(s):

Shyam Prabhakaran ◽

Laurel J Smit

Keyword(s):

Randomised Controlled Trial ◽

Acute Stroke ◽

Controlled Trial ◽

Cluster Randomised Controlled Trial ◽

Evidence Based ◽

Treatment Protocols ◽

Evidence Based Treatment ◽

Cluster Randomised ◽

Swallowing Dysfunction ◽

Randomised Controlled

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Systematic review of the effects of evidence-based psychotherapies on neurocognitive functioning in mood disorders

Australian & New Zealand Journal of Psychiatry ◽

10.1177/00048674211031479 ◽

2021 ◽

pp. 000486742110314

Author(s):

Samantha J Groves ◽

Katie M Douglas ◽

Melissa Milanovic ◽

Christopher R Bowie ◽

Richard J Porter

Keyword(s):

Systematic Review ◽

Mood Disorders ◽

Interpersonal Relationships ◽

Neurocognitive Impairment ◽

Neurocognitive Functioning ◽

Evidence Based ◽

Current Standard ◽

Treatment Protocols ◽

Analytic Review ◽

Evidence Based Psychotherapy

Objective: Neurocognitive impairment is considered a core feature of mood disorders. Research has shown that neurocognitive impairment often persists beyond mood symptom resolution and can have significant deleterious effects on interpersonal relationships, academic achievement, occupational functioning and independent living. As such, neurocognitive impairment has become an important target for intervention. In this systematic review, we aimed to examine the extant literature to ascertain whether current standard evidence-based psychotherapies can improve neurocognitive functioning in mood disorders. Method: Studies examining changes in neurocognitive functioning following evidence-based psychotherapy were identified using MEDLINE, PsycINFO and Web of Science databases. Given the heterogeneity of study procedures, treatment protocols and patient samples, a narrative rather than meta-analytic review technique was employed. Results: Nineteen studies (21 articles) met inclusion criteria. There was preliminary evidence of improved executive functioning following evidence-based psychotherapy for Major Depressive Disorder and Bipolar Disorder. There was also some signal of reduced negative biases in emotional information processing following psychotherapy in depression. Due to methodological variability across studies however, it was difficult to draw clear conclusions. Conclusion: Findings from the current review suggest that evidence-based psychotherapies may influence some aspects of neurocognitive functioning in mood disorders. This continues to be an ongoing area of importance and warrants further research.

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Simplified treatment algorithm for the management of trauma-induced hemorrhage without viscoelastic testing

Trauma Surgery & Acute Care Open ◽

10.1136/tsaco-2021-000779 ◽

2021 ◽

Vol 6 (1) ◽

pp. e000779

Author(s):

Sebastian Casu

Keyword(s):

Major Trauma ◽

Point Of Care ◽

Treatment Algorithm ◽

Standard Of Care ◽

Trauma Team ◽

Trauma Patients ◽

Treatment Protocols ◽

Treatment Algorithms ◽

Number Of Treatment ◽

Uncontrolled Bleeding

Uncontrolled bleeding after major trauma remains a significant cause of death, with up to a third of trauma patients presenting with signs of coagulopathy at hospital admission. Rapid correction of coagulopathy is therefore vital to improve mortality rates and patient outcomes in this population. Early and repeated monitoring of coagulation parameters followed by clear protocols to correct hemostasis is the recommended standard of care for bleeding trauma patients. However, although a number of treatment algorithms are available, these are frequently complex and can rely on the use of viscoelastic testing, which is not available in all treatment centers. We therefore set out to develop a concise and pragmatic algorithm to guide treatment of bleeding trauma patients without the use of point-of-care viscoelastic testing. The algorithm we present here is based on published guidelines and research, includes recommendations regarding treatment and dosing, and is simple and clear enough for even an inexperienced physician to follow. In this way, we have demonstrated that treatment protocols can be developed and adapted to the resources available, to offer clear and relevant guidance to the entire trauma team.

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Novel Treatments and Technologies Applied to the Cure of Neuroblastoma

Children ◽

10.3390/children8060482 ◽

2021 ◽

Vol 8 (6) ◽

pp. 482

Author(s):

Irene Paraboschi ◽

Laura Privitera ◽

Gabriela Kramer-Marek ◽

John Anderson ◽

Stefano Giuliani

Keyword(s):

Research Effort ◽

Treatment Strategies ◽

Adverse Outcomes ◽

Treatment Protocols ◽

Ongoing Research ◽

Hematopoietic Stem ◽

Novel Treatments ◽

Therapeutic Modalities ◽

High Risk Disease ◽

Novel Treatment Strategies

Neuroblastoma (NB) is the most common extracranial solid tumour in childhood, accounting for approximately 15% of all cancer-related deaths in the paediatric population1. It is characterised by heterogeneous clinical behaviour in neonates and often adverse outcomes in toddlers. The overall survival of children with high-risk disease is around 40–50% despite the aggressive treatment protocols consisting of intensive chemotherapy, surgery, radiation therapy and hematopoietic stem cell transplantation2,3. There is an ongoing research effort to increase NB’s cellular and molecular biology knowledge to translate essential findings into novel treatment strategies. This review aims to address new therapeutic modalities emerging from preclinical studies offering a unique translational opportunity for NB treatment.

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Implementation support for contingency management: preferences of opioid treatment program leaders and staff

Implementation Science Communications ◽

10.1186/s43058-021-00149-2 ◽

2021 ◽

Vol 2 (1) ◽

Author(s):

Kelli Scott ◽

Shelly Jarman ◽

Samantha Moul ◽

Cara M. Murphy ◽

Kimberly Yap ◽

...

Keyword(s):

Performance Feedback ◽

Contingency Management ◽

Scale Up ◽

Team Approach ◽

Evidence Based ◽

Implementation Support ◽

Training Performance ◽

Opioid Treatment ◽

Treatment Providers ◽

External Facilitation

Abstract Background Contingency management (CM), a behavioral intervention that provides incentives for achieving treatment goals, is an evidence-based adjunct to medication to treat opioid use disorder. Unfortunately, many front-line treatment providers do not utilize CM, likely due to contextual barriers that limit effective training and ongoing support for evidence-based practices. This study applied user-informed approaches to adapt a multi-level implementation strategy called the Science to Service Laboratory (SSL) to support CM implementation. Methods Leaders and treatment providers working in community-based opioid treatment programs (OTPs; N = 43) completed qualitative interviews inquiring about their preferences for training and support implementation strategies (didactic training, performance feedback, and external facilitation). Our team coded interviews using a reflexive team approach to identify common a priori and emergent themes. Results Leaders and providers expressed a preference for brief training that included case examples and research data, along with experiential learning strategies. They reported a desire for performance feedback from internal supervisors, patients, and clinical experts. Providers and leaders had mixed feelings about audio-recording sessions but were open to the use of rating sheets to evaluate CM performance. Finally, participants desired both on-call and regularly scheduled external facilitation to support their continued use of CM. Conclusions This study provides an exemplar of a user-informed approach to adapt the SSL implementation support strategies for CM scale-up in community OTPs. Study findings highlight the need for user-informed approaches to training, performance feedback, and facilitation to support sustained CM use in this setting.

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Comprehensive physiotherapy management in covid-19 – a narrative review

Scientia Medica ◽

10.15448/1980-6108.2020.1.38030 ◽

2020 ◽

Vol 30 (1) ◽

pp. 38030 ◽

Cited By ~ 1

Author(s):

Deivendran Kalirathinam ◽

Raj Guruchandran ◽

Prabhakar Subramani

Keyword(s):

Narrative Review ◽

World Health ◽

Evidence Based ◽

The United Kingdom ◽

Global Pandemic ◽

Related Quality ◽

Health Related ◽

Novel Coronavirus ◽

Health Organization ◽

The Uk

The 2019 novel coronavirus officially named as coronavirus disease 2019 (COVID-19) pandemic by the World Health Organization, has spread to more than 180 countries. The ongoing global pandemic of severe acute respiratory syndrome coronavirus, which causes COVID-19, spread to the United Kingdom (UK) in January 2020. Transmission within the UK was confirmed in February, leading to an epidemic with a rapid increase in cases in March. As on April 25- 2020, there have been 148,377 confirmed cases of COVID-19 in the UK and 20,319 people with confirmed infection have died. Survival of critically ill patients is frequently associated with significant functional impairment and reduced health-related quality of life. Early physiotherapy and community rehabilitation of COVID-19 patients has recently been identified as an essential therapeutic tool and has become a crucial evidence-based component in the management of these patients. This comprehensive narrative review aims to describe recent progress in the application of physiotherapy management in COVID 19 patients. Assessment and evidence- based treatment of these patients should include prevention, reduction of adverse consequences in immobilization, and long-term impairment sequelae. A variety of techniques and modalities of early physiotherapy in intensive care unit are suggested by clinical research. They should be applied according to the stage of the disease, comorbidities, and patient’s level of cooperation.

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